Individual
ANDREA MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 GRAND AVE BLDG 27, SAN LUIS OBISPO, CA 93407-9000
(805) 756-5260
(805) 756-7001
Mailing address
1 GRAND AVE BLDG 27, SAN LUIS OBISPO, CA 93407-9000
(805) 756-5260
(805) 756-7001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
51752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51752
CALIFORNIA PHARMACIST LICENSE
CA
Enumeration date
04/11/2013
Last updated
04/11/2013
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